Schore, A. (2001) | References | Narcissus and the Child

What This Research Found

Allan Schore's influential paper presents a comprehensive model of how early relational trauma shapes the infant's developing brain. Published in the Infant Mental Health Journal and cited in foundational trauma and attachment literature worldwide, this work synthesises developmental neuroscience, attachment theory, and infant psychiatry to explain why the first three years of life are so critical—and what happens when they go wrong.

The right hemisphere develops first and through relationship. Schore demonstrates that during the first three years of life, the right hemisphere of the brain develops with marked priority over the left. The right hemisphere specialises in reading emotional faces, processing prosody (the emotional tone in speech), detecting threat, regulating arousal, and governing the implicit sense of self. These functions are essential for early survival—the infant must read the caregiver's emotional state and regulate their own stress long before language develops. Crucially, this right hemisphere development occurs through attuned interactions with caregivers. The neural architecture of affect regulation is literally constructed in the context of the caregiver-infant relationship.

Early relational trauma becomes imprinted in developing neural systems. When the primary caregiver is the source of trauma rather than safety—through abuse, neglect, chronic misattunement, or the unpredictability characteristic of narcissistic parenting—the infant's right brain must adapt to this environment. Because this occurs during critical periods of maximum neuroplasticity, these adaptations become imprinted in neural circuits. The stress response system calibrates for an environment of chronic threat. The attachment system organises around an unreliable caregiver. The affect regulation circuits develop without the attuned input they need to function properly.

The damage occurs below the level of language and conscious memory. Because right hemisphere development precedes left hemisphere language acquisition, early relational trauma is encoded in implicit, procedural memory rather than explicit, narrative memory. The patterns laid down in these first years become the operating system upon which all later development builds. Survivors often cannot articulate what happened—the trauma predates their capacity for autobiographical memory—yet the neural adaptations persist, shaping how they regulate emotion, respond to stress, and relate to others throughout their lives.

The mechanism is psychobiological dysregulation. Schore introduces the concept of the caregiver as a "psychobiological regulator" of the infant's immature systems. When the caregiver is attuned, their regulated nervous system helps organise the infant's dysregulated states through what Schore calls "psychobiological attunement." But when the caregiver is themselves dysregulated—as narcissistic parents typically are—they cannot provide this regulatory function. Worse, they may actively dysregulate the infant through their own emotional volatility, intrusiveness, or withdrawal. The infant's developing brain thus learns to expect dysregulation rather than co-regulation.

Why This Matters for Survivors

If you were raised by a narcissistic parent, Schore's research explains why the effects feel so foundational—why it seems like something is wrong at the core rather than on the surface.

The damage began before you could protect yourself—or even remember. Your right brain was being constructed during those first three years, and your narcissistic parent's chronic misattunement, unpredictability, or abuse became part of that construction. You didn't choose these adaptations; they happened at a neural level before you had the cognitive capacity to understand what was occurring. The hypervigilance, the difficulty regulating emotions, the sense that something fundamental is off—these aren't character flaws or signs of weakness. They're the neural signature of a brain that was built under conditions of relational trauma.

Your struggles with emotional regulation make neurobiological sense. Schore's research shows that the capacity to regulate emotions is built through thousands of repetitions of attuned caregiver response during critical developmental windows. When a caregiver reliably responds to infant distress with soothing, the infant's developing prefrontal cortex builds connections that will eventually enable self-regulation. When this doesn't happen—when the caregiver is unavailable, dysregulating, or the source of the distress—those regulatory circuits don't develop properly. You're not failing at something you should be able to do; you're working with neural infrastructure that was never properly built.

This explains why insight alone doesn't heal. You may understand intellectually what happened to you. You may have spent years in therapy developing sophisticated frameworks for your family dynamics. Yet the patterns persist. Schore's research explains why: the damage occurred in right-hemisphere implicit memory systems, before language developed, before you could form conscious memories. Insight—which relies on left-hemisphere verbal processing—cannot directly access what was damaged. This is why healing from early relational trauma typically requires more than talk therapy alone; it requires corrective relational experiences that engage the right hemisphere.

Your hypervigilance was adaptive. The child of a narcissistic parent had to become an expert reader of the parent's emotional states to survive. Your brain devoted developmental resources to threat detection and caregiver monitoring because that's what your environment demanded. The hypervigilance that now feels maladaptive in safe relationships was once essential for navigating an unpredictable caregiver. Understanding this can help you stop pathologising yourself and start working with your nervous system rather than against it.

Clinical Implications

For psychiatrists, psychologists, and trauma-informed healthcare providers, Schore's research has direct implications for assessment and treatment of early relational trauma.

Assess developmental timing with clinical precision. When did the patient's adverse experiences begin? Schore's model identifies the first three years as the critical period for right hemisphere development and affect regulation capacity. Patients whose trauma occurred during this window—before they could form explicit memories—may present with pervasive regulatory difficulties that resist conventional insight-oriented treatment. Understanding that the injury occurred during construction of the brain's operating system, rather than as an insult to an already-developed system, informs realistic expectations and treatment planning.

Prioritise the therapeutic relationship as the mechanism of change. Schore's framework implies that therapeutic change in early relational trauma occurs through right-brain to right-brain communication—prosody, facial expression, timing, and emotional attunement—more than through verbal interpretation. The therapist must become what Schore calls a "psychobiological regulator," providing the attuned responsiveness that was missing in early life. This isn't just about creating rapport; the relationship itself, over time, can help build the regulatory circuitry that was never properly constructed.

Consider treatment intensity that matches developmental depth. Standard outpatient therapy (weekly 50-minute sessions) may be insufficient for patients whose affect regulation circuitry was shaped during critical periods. Schore's work suggests that interventions approximating the conditions of early development—frequent, consistent, emotionally attuned—may be necessary for meaningful neural change. This has implications for treatment planning: more frequent sessions, longer sessions, adjunctive body-based approaches, and realistic expectations about treatment duration measured in years rather than months.

Integrate body-based and right-hemisphere-engaging interventions. Since the damage occurred in implicit, right-hemisphere systems, interventions that engage these systems directly—EMDR, Somatic Experiencing, sensorimotor psychotherapy, attachment-focused treatments—may access the injury more directly than purely verbal approaches. Schore's work supports combining relational attunement with modalities that engage procedural memory and the body's role in affect regulation.

Broader Implications

Schore's research on early relational trauma extends beyond individual therapy to illuminate patterns at family, institutional, and societal levels.

The Mechanism of Intergenerational Transmission

If affect regulation capacity is built through the caregiver's regulated presence, what happens when the caregiver themselves lacks regulatory capacity? The narcissistic parent who cannot regulate their own emotions cannot provide the regulatory scaffolding their infant needs. The child grows up with compromised affect regulation, becomes a parent, and transmits the same deficit to the next generation. This is the mechanism of intergenerational trauma—not mystical inheritance but neurobiological reality operating through the caregiver-infant relationship. Breaking these cycles requires interventions that address parental regulatory capacity, not just parenting behaviours.

Implications for Child Welfare and Foster Care

Schore's work has direct implications for child welfare policy. Foster care systems that move children between placements during critical periods disrupt exactly the relationships needed for regulatory development. Institutional care settings that provide physical needs but not attuned relational engagement fail to provide what developing brains require. Policies supporting consistent caregiving relationships, even when birth parents cannot provide them, are not merely humane preferences—they are neurobiologically necessary for healthy development.

Understanding the Narcissistic Parent's Impact

The narcissistic parent creates precisely the conditions Schore identifies as traumatic for developing brains: chronic unpredictability, where emotional availability depends on the parent's needs rather than the child's; misattunement, where the infant's emotional states are ignored, misread, or met with the parent's unrelated states; and role reversal, where the infant must regulate the parent rather than the other way around. The infant cannot predict when connection will be available, cannot develop reliable models of the social world, and must devote developmental resources to monitoring the parent rather than exploring and learning. The resulting neural adaptations are precisely calibrated to this pathological caregiving environment.

Early Intervention as Prevention

Schore's framework suggests that intervention during critical periods may prevent neural adaptations from consolidating. If we can identify at-risk dyads—narcissistic parents, parents with unresolved trauma, parents struggling with addiction or mental illness—and provide intensive early intervention that supports parental regulatory capacity and infant attunement, we may prevent the intergenerational transmission of trauma. The public health return on investment for such early intervention would likely be substantial, measured in reduced later mental health costs, criminal justice involvement, and lost productivity.

The Limits of Adult Treatment

Schore's model also illuminates why treating adult narcissism is so difficult. The narcissistic adaptations were encoded during critical periods of maximum plasticity, becoming part of the brain's fundamental architecture. Adult treatment must work against consolidated neural patterns that were built when the brain was maximally receptive to experience. This doesn't mean change is impossible—adult neuroplasticity exists—but it explains why treatment is slow, requires sustained effort, and often produces limited results. Prevention through early intervention may ultimately be more effective than attempts to reverse decades-old neural adaptations.

Legal and Policy Considerations

Family courts making custody decisions should understand that transitions between caregivers during the first three years may have neurobiological costs beyond obvious psychological stress. Judges awarding custody to narcissistic parents because they present well in court may be enabling ongoing developmental trauma. Criminal justice systems might consider how early affect regulation failures contribute to later difficulties with impulse control—not as excuse, but as context for rehabilitation approaches that address regulatory capacity.

How This Research Is Used in the Book

Schore's 2001 paper is cited in Chapter 6: The False Self and Chapter 10: Building the Maze to explain the neurobiological mechanisms by which early relational trauma shapes the developing brain.

In Chapter 6, Schore's work establishes why human infants are so vulnerable to relational trauma:

"During the first three years of life, Elena's right hemisphere develops with marked priority over the left. The reason is simple: our right hemisphere specialises in those functions most essential for early survival. This includes reading emotional faces and processing prosody (patterns of stress and intonation in spoken language.) It begins detecting threat and regulating arousal. The left hemisphere's specialisations while important—such as language, logic, and sequential processing—can actually wait. The right hemisphere cannot."

The chapter then describes what this means for the infant of a narcissistic parent:

"The infant of the narcissistic parent experiences chronic unpredictability."

In Chapter 10, Schore's research explains how the reward system develops through early relational experience and how this development goes wrong when caregiving is inconsistent:

"During the first months of life, evidence suggests the reward system begins learning the contingencies of social interaction. When caregiving is consistent, the system likely learns: 'Social cues reliably predict reward.' Dopamine neurons develop appropriate prediction models; opioid release becomes associated with ordinary caregiving experiences."

The chapter continues:

"In healthy development, the infant has learned that their bids for connection generally produce response. The reward system is calibrated for a social world that is, on average, responsive. Dopamine and opioid systems are sensitised to ordinary social cues."

Schore's framework is also applied to understand the development of empathy deficits:

"The empathy network, like the stress and reward systems, can develop as skin or as scales. In healthy development, resonance is automatic and flexible (skin). In disrupted development, resonance is blocked or selective—the AI [anterior insula] activating only for those who matter to the self (scales)."

Throughout the book, Schore's work demonstrates that narcissistic abuse during childhood doesn't just cause psychological distress—it shapes the neural architecture upon which personality and relational capacity are built.

Limitations and Considerations

Responsible engagement with Schore's work requires acknowledging several important limitations.

Complexity of critical period boundaries. While Schore identifies the first three years as particularly critical for right hemisphere development, the precise boundaries and the degree to which later experience can modify early patterns remain subjects of ongoing research. Individual variation in critical period timing exists, and some plasticity persists into adulthood.

Translation to clinical protocols. Schore's synthesis is masterful at the theoretical level, but translating "provide attuned relational experience during critical periods" into specific clinical protocols remains challenging. For adult treatment, the question of how to approximate critical period conditions therapeutically is not fully resolved.

The challenge of measuring change. How do we know when therapeutic intervention has successfully rebuilt affect regulation capacity? Subjective report and behavioural observation are imperfect measures. Neuroimaging could theoretically demonstrate neural changes but is not practical for routine clinical use.

Cultural considerations. Schore's work draws primarily on Western attachment research. What constitutes "attuned caregiving" varies across cultures, and the specific expressions of healthy affect regulation development may differ. Clinicians should be cautious about applying a universal template across diverse populations.

Risk of determinism. There is a risk that Schore's framework could be interpreted as meaning early trauma creates permanent, irreversible damage. While the research shows that early adaptations are deeply embedded, adult neuroplasticity means change remains possible—albeit harder than if the foundation had been properly built initially.

Historical Context

Published in 2001, this paper represents a mature statement of Schore's "regulation theory"—the framework showing how early relationships shape brain development. It built on his groundbreaking 1994 book Affect Regulation and the Origin of the Self and integrated subsequent developments in neuroimaging, attachment research, and trauma studies.

The paper appeared at a pivotal moment in developmental neuroscience. Brain imaging technology had matured enough to reveal structural and functional differences associated with early experience. Attachment research had generated robust longitudinal findings linking early caregiving quality to later outcomes. And the field of infant mental health was ready for a neurobiological framework that could explain the mechanisms underlying clinical observations.

Schore's integration was distinctive in bridging neuroscience, psychoanalysis, and attachment theory—fields that had often operated in isolation. His emphasis on right hemisphere function, implicit memory, and the body's role in affect regulation anticipated later developments in body-based trauma treatment and the polyvagal theory.

The paper has been widely cited across developmental psychology, trauma studies, attachment research, and clinical practice. Its framework—that the caregiver literally builds the infant's brain through attuned interaction—has become foundational for understanding early development and the origins of later psychopathology.

The Effects of Early Relational Trauma on Right Brain Development, Affect Regulation, and Infant Mental Health

APA Citation